The Challenge: Industrial-Era Care in a Modern World
Windber Medical Center, a nearly century-old hospital, was founded with a paternalistic, industrial-era philosophy. Facing competition, declining reimbursements, and a predicted demise within five years, the hospital needed a revolutionary change. The existing culture prioritized the system over the patient, creating an environment that was often confusing and intimidating for those seeking care.
The change management mission was to create a hospital environment that patients would not just like, but love—one that embraced holistic, patient-centered care and empowered patients in their own healing.
The Diagnosis: Choosing the Planetree Philosophy
Under new leadership, the hospital chose the Planetree model as its path forward. This philosophy puts the patient at the center of the care mission, embracing the concept that healing must address the needs of the mind and spirit as well as the body. Key elements include:
- Open communication
- Patient choices and empowerment
- Family and friend involvement
- A healing environment featuring music, art, and architecture
- Use of complementary therapies like massage, yoga, and aromatherapy
Despite a "wait and see" attitude from most physicians and resistance from some staff, the board and president moved forward with the decision.
Overcoming Organizational Resistance
The transformation challenged the entire workforce, particularly a core group of physicians who controlled patient flow and a culture resistant to ceding power. The new president initiated change by first listening—meeting with every employee to understand the culture—and then by taking decisive action.
Key strategies to manage the change included:
- Executive Action: The president replaced the entire senior management team twice over three years to build a team of warm, caring, and empowering leaders.
- Employee Training: Staff were sent to the Disney Institute for customer service training, and all employees received Emotional Quotient (EQ) training to improve interpersonal skills.
- Physician Engagement: Leadership identified and empowered physician champions who believed in patient empowerment to help steer conversations and gain buy-in from their peers.
- Persistent Communication: The president held frequent town meetings with all employees to reinforce the vision of patient-centered care.
- Cultural Accountability: It took nearly three years to revise the employee evaluation system to allow for the removal of staff who were fundamentally opposed to the new philosophy.
The Intervention: Creating a Healing Environment
The hospital made fundamental changes to its operations and environment. Bread was baked in hallways, popcorn popped in the lobby, and massage was offered to patients and staff. More substantively, the hospital implemented:
- Open medical records and unlimited visiting hours.
- Pets for pet therapy.
- A "Center for Life" for seniors with access to a gym and preventative health options.
- Birthing suites with midwives, Jacuzzi tubs, and beds for families.
- Empowerment for employees to resolve patient issues with a budget of up to $300 per incident.
Feedback was gathered through "Planetree teams" composed of peers, which held venting sessions and provided anonymous reports to leadership. A crucial turning point came when a financial windfall allowed the hospital to give key caregivers a 30% raise, affirming the lesson that happy, well-paid employees are critical to success.
Quantifying the Results
The transformation led to significant, measurable improvements in patient outcomes.
- Exhibit 1: The average length of stay for patients decreased.
- Exhibit 2: The rate of nosocomial (hospital-acquired) infections was reduced.
- Exhibit 3: The hospital